Glucagon

glucagon-extinguisherThe red box.

I’ve shown it to coworkers. To family. To friends. I open the box up, show them the contents, and go through a complicated pantomime of what they would need to do. (Marcel Marceau is rolling in his grave. Silently, of course.) I had one staff meeting where my team played Rock Paper Scissors for who would use the red box. Make no mistake – it was the loser who got to administer it on me.

The red box is my glucagon kit and in all my years of T1, it has been used twice on me, and I was awake each time (although it was close). If you are having a severe hypoglycemic episode and can’t ingest glucose (because you’re unconscious or throwing up or can’t get another gram of glucose into you by mouth), it’s what’s going to help you.

It’s an insurance policy. The kits do expire and they’re aren’t cheap, even with a prescription, but it’s worth having – if you have someone with you who knows what the hell to do with it. It’s not a “take it and jab it into her butt and there you go” sort of deal. While you are incapacitated (and let’s be honest… if your blood sugar is 25, you’re not exactly spouting off the Declaration Proclamation verbatim, although you may think you are), the individual you trusted to use this kit must follow a set of directions that involves a few steps. It’s not like someone is going to rifle through your things and say…

“Hey, look! A glucagon emergency kit! Let me sit down and read the directions and get comfortable with this concept and figure out what to do…wow, there are a lot of steps… before I plunge a needle into your…”

If they don’t know what it is, what it’s for, what they need to do, it’s going to sit there.

So, here’s my challenge for you today.

If you have a glucagon kit, talk about it with the people who you love and hang out with you. If you have someone you work with that you trust, talk with him/her. I know that some people don’t want to disclose diabetes at work, but the last thing you want is to pass out and not have anyone understand why.)

  1. Show them where it resides (in your backpack, in the refrigerator, in your bedside drawer).
  2. Explain what it will do for you and what it won’t do.
  3. Tell them that you will do everything to avoid ever having to use this, but if it does need to be used, that you trust them to do whatever it takes to keep you alive – and it will keep you alive.
  4. Pull out the kit, go over the instructions, and answer any questions that they might have about it.
  5. Thank them. This is so important. Thank them for caring enough to help you if you can’t help yourself. It’s just as scary for them as it is for you when you are crazy low and/or unconscious.

 

I have an Eli Lilly Glucagon Emergency Kit for Low Blood Sugar. And you know what Eli Lilly did?

They made an app for the iPad and iPhone, giving you easy visuals to share and show – and prepare in case something does happen.

This is the website where you can get more info and click to download the app. I put it on my iPhone and it’s very easy to use:

www.lillyglucagon.com

app-screenshots

Until there are easier ways to administer glucagon (and there will be, because I believe that what is currently in clinical trials will become FDA approved – administered nasally versus intramuscular injection? Oh, yes.), it’s important that we give ourselves and those who are around us the tools and resources to help. (That nasal glucagon link? They are still recruiting, so you can help us all out if you are near a trial center.)

Now, what if you don’t have a glucagon kit?

Get one. Ask your doctor for a prescription and get one from your pharmacy. (Note: check the expiration date on the kit while you are standing at the pharmacy window. Do not accept a kit that has less than a year left to use it. Unlike some other supplies, this one will become less potent after the expiration date and because it’s expensive, don’t waste your money on a kit with just a few months left.)

As I said before, they are expensive and it’s one of the few things about my diabetes management in which I want to let expire.

Why do I tell you this?

I had a severe hypo a few weeks ago. Severe enough that I needed John to help me, because I could not longer use my legs to get more glucose. I was scared.

And after the disastrous event, both of us admitted that the red box was about a minute away from being used. If I hadn’t forced (and kept down) another juice box, it would have been a reality. I am thankful that I took the time to show John how it should be used and trust his judgement. I want everyone to be thankful. And everyone to have a red box – and never use it.

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